Purchase this article with an account.
F Neri, I Pellistri, D Dazzi, M Salvi; Thyroid-associated Ophthalmopathy:study Of The Clinical Subtypes According To Nunery And Solovyeva Classifications . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1484.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To compare the two classifications of TAO by Nunery and Solovyeva. Methods: The classification of TAO is mainly based on clinical criteria: according to Nunery (Ophth Clin North Am, 1991), Type 1 TAO is due to orbital fibroblasts stimulation by immune factor(s), resulting in symmetric propotosis and minimal inflammation without restrictive myopathy , whereas Type 2 TAO is an autoimmune myositis with asymmetry, severe inflammation and optic neuropathy; Solovyeva (Orbit, 1989) has proposed a classification based on hystopathological findings and has divided TAO in edematous exophthalmos, the most severe form with diplopia, inflammation, neuropathy and endocrine myopathy, with predominant eye muscle involvement but minimal inflammation and proptosis and no neuropathy. In this sturdy we have classified 323 TAO patients, 277 women and 46 men, according to the different subgroup criteria. We assessed proptosis, lid signs, chemosis, redness, IOP, muscle dysfunction, corneal damage, visual field abnormalities and abnormal CT scan as well as sex, age and smoking. Results: Patients with Type 2 TAO had more marked proptosis (p<0.0001), a significantly prevalence of neuropathy( p<0.05), a prevalence of smokers and were older (p<0.05) than those with Type 1 TAO, but did not have significant eye asymmetry, and different F/M ratio, when compared with the findings of Nunery. Patients with endocrine myopathy had significant less proptosis (p<0.0001), but no difference of age, sex and prevalence of smokers, when compared to patients with edematous exophthalmos, as described by Solovyeva. Conclusion: Our findings support the latter group subdivision, which seems to recognize two pathophysiologically different TAOs. The classification suggested by Nunery distinguishes mainly mild from severe clinical TAO.
This PDF is available to Subscribers Only